Technical Assistance (TA) Request Form - 9043

Technical Assistance Request and Evaluation (TARE)

Documents and Forms

Document Name Document Type
Form DHS Form 9043 Technical Assistance (TA) Request Form - 9043 Form and Instruction
DHS Form 9043 CISA Technical Assistance (TA)Request Form CISA_Technical_Assistance_Request_Form_7_2020.pdf Form and Instruction
DHS Form 9043 CISA Technical Assistance (TA)Request Form CISA_Technical_Assistance_Request_Form_7_2020.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	Technical Assistance (TA) Request Form - 9043	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	DHS Form 9043	CISA Technical Assistance (TA)Request Form	CISA_Technical_Assistance_Request_Form_7_2020.pdf		Yes	Yes	Fillable Fileable

Line of Business: Homeland Security

Subfunction: Key Asset and Critical Infrastructure Protection

Privacy Act System of Records
Title: Department of Homeland Security Mailing and Other Lists System of Records	FR Citation: 73 FR 71659

Number of Respondents: 47	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 75 %

	Approved	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	94	94
Annual IC Time Burden (Hours)	39	39
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.